Troubles of overcrowding at the Thelle Mogoerane Hospital, especially in the neonatal ward, have been an ongoing concern for staff at the hospital, the South African Human Rights Commission (SAHRC) has heard.
Staff members were speaking to SAHRC officials during a site inspection at the hospital in Vosloorus, east of Johannesburg, on Wednesday.
This after six newborn babies died following a Klebsiella pneumonia outbreak at the hospital.
"As organised labour, we have always been crying about overcrowding at the hospital but our cries have always fallen on deaf ears," union representative Lebohang Nkoana told the commission during the inspection.
Nkoana said overcrowding in wards was a dire concern and it exposed staff and patients to diseases.
He gave an example of a ward that had no air conditioning but housed patients most of whom have tuberculosis, which then exposed staff members to the disease. He said a nurse was recently treated for TB as a result.
Outsourcing nurses
Nkoana added that at some point, because of overcrowding in some wards, a nurse was strangled by a psychiatric patient because they were not in the area they were meant to be in.
"We have a psych unit here but it's overcrowded and then patients are taken to wards where they don't belong. When you take a psych patient to another ward without supervision it's a danger to them and other staff and patients," he said.
Nkoana said because of overcrowding and lack of permanent staff, the hospital was outsourcing nurses from agencies to help.
Meanwhile, in the neonatal ward, which has 61 beds, six babies died due to Klebsiella infection, and staff workers working there raised the same issues with the commission.
"At the moment we have 52 babies at the ward. What makes the infection spread is poor hygiene. We are doing our best to improve hygiene in the hospital," the hospital's clinical manager Constance Ndobe told the SAHRC officials.
She added that while the overcrowding had been reported to hospital CEO Nomonde Mqhayi, not much could be done because of the shortage of hospitals in the province.
Hospital sometimes 'closes'
"Gauteng itself is overcrowded, and that's the challenge," Ndobe said.
When the flow of patients becomes unmanageable, the hospital usually closes.
"When we close it, we close it for people who come in by ambulances, but for people walking in, it is not closed, because we cannot control them," she said.
Ndobe said neonatal patients were usually transferred to Chris Hani Baragwanath Hospital in Soweto and Steve Biko Academic Hospital in Pretoria.
Regarding the recent outbreak in the ward, Ndobe said the hospital was receiving all the support it needed from the health department's provincial office.
While the department said it would move newborn babies from Thelle Mogoerane to the Nelson Mandela Children's hospital and Charlotte Maxeke, which are both in Parktown, Ndobe said the move had not yet happened because there were still some administrative issues that needed to be dealt with.
No basic hygiene
"We can't just move babies to other hospitals. There are steps to be followed because these are sick babies and so we have to follow the protocol," she said.
She added that preparations at the Nelson Mandela Children's Hospital still needed to get underway so that the outbreak would not occur again when the babies were eventually moved.
"We have to ensure that there is equipment and other consumables before conducting the move. We will also need staffing that other side," she said.
However, a sister in charge of the neonatal ward at Thelle Mogoerane insisted that the biggest concern was shortage of staff and equipment in the ward.
"Another thing is the structure of the ward. People are just walking past the passage. When you enter there should be a washing basin for hands, which is not the case at the ward," the nurse told SAHRC officials.
She added that overcrowding had been a challenge since she first took charge of the ward.
Investigation underway
"Twelve babies were infected with Klebsiella and six have passed away, while one was treated and discharged and another was transferred to Steve Biko and was found negative. Four remain here, two of which are negative and the other two positive," she said.
The SAHRC's provincial manager Buang Jones said the nature of overcrowding in Gauteng hospitals was a concern that needed attention.
He added that following the inspection at the hospital, the SAHRC was also concerned about hygiene.
"While the hospital may appear to be superficially clean and sterile, we are concerned that it may not be meeting the standards of cleanliness. A thorough investigation to analyse this has to be embarked upon," Jones said.
He added that if the crisis of overcrowding was not dealt with, more fatalities would occur.
The commission would be assisting the parents of the six babies who had died with legal advice, he added.
"We want the department to provide us with a clear turnaround plan on how they will address issues pertaining to overcrowding [and] staff shortages.
"We also want to work with labour to address some of their concerns pertaining to governance and management at the hospital," he said.
Jones has urged whistleblowers to come forward with information pertaining to acts of maladministration at the hospital.